Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.14 / $161.12 / $161.12	Facility		$59.14	$161.12	$161.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.07 / $10.07 / $21.53	Facility	26	$10.07	$10.07	$21.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.16 / $34.15 / $94.93	Professional		$29.16	$34.15	$94.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $14.20 / $52.35	Professional	26	$10.07	$14.20	$52.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $20.29 / $43.09	Professional	TC	$17.89	$20.29	$43.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56,799.99 / $68,899.99 / $81,099.99	Facility		$56,799.99	$68,899.99	$81,099.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.01 / $26.56 / $48.85	Professional		$10.01	$26.56	$48.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.99 / $47.36 / $63.98	Professional		$31.99	$47.36	$63.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $18.93 / $25.72	Professional	26	$12.24	$18.93	$25.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.26 / $26.18 / $35.90	Professional	TC	$18.26	$26.18	$35.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.04 / $32.34 / $49.40	Professional		$17.04	$32.34	$49.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.90 / $44.42 / $55.84	Facility		$34.90	$44.42	$55.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.68 / $54.04 / $85.19	Professional		$33.68	$54.04	$85.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.36 / $25.72	Professional	26	$12.30	$20.36	$25.72
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $26.18 / $35.90	Professional	TC	$18.70	$26.18	$35.90
United Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $37.17 / $72.48	Professional		$35.00	$37.17	$72.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.80 / $15.87 / $29.64	Professional	26	$14.80	$15.87	$29.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $22.93 / $50.55	Professional	TC	$19.71	$22.93	$50.55